ReadyNutrition Readers, as we begin the Fall season, we know that winter is right around the corner. The advent of the cold temperatures and inhospitable weather pose a whole different set of challenges that hold sway for you and your families when outdoors. As the saying governs, “An ounce of prevention is worth a pound of cure,” and there is nothing that can be much more true than this saying used in reference to preparations for the winter months. It is my hope that this articles and the ones that follow on the subject will give information to lay in supplies for the cold, nasty months that will help you perform first aid outdoors more effectively.

I have written articles on bug-out/A-bags that have listed some of the extra accouterments I need during the winter months in Montana. Keep in mind: freezing temperatures will kill you in Montana or in the Florida. Geographic location is important to consider if you are in a high-risk area as the former state, but temperature is unbiased as to geography. The preparedness mindset requires us to be vigilant in all circumstances and know that things can “head south” at any given time.

Winter Survival is Dependent on the Supplies You Carry

From a Trauma Medicine perspective, there are a few things you can utilize to aid you in the wintertime that may make the difference for you. Let’s list and discuss them, their uses, and why you should consider them.

1. Maintain your body heat with a good sleeping bag.

A good blanket and/or a sleeping bag are absolutely essential during the winter months. You must do your utmost to store them in a waterproof bag of some sort. Hypothermia can be offset by warming your patient. In this vein, you should have adequate fire-starting materials, as well as sustainment capabilities to keep a small fire going.

2. Having a way to quickly make fire is essential.

There are those Coleman-type fire starters that in appearance resemble particleboard. Best advice on this is to pick up a fire log and then cut it up. Guess what? It’s the same thing! The little fire starters can run about $4-5, and for that price you can buy a whole fire log! Cut it up and store it in slivers in Ziploc bags. Along with these I highly recommend hexamine tablets (commonly referred to as “heat tablets”) and a small folding stove. You can pick up the stove and a box of 24 heat tablets for around $7-8 and it is well worth it. Each hexamine tablet burns for about 9 minutes, and that goes a long way in heating up a canteen cup with water.

3. Have a way to heat the body from the inside out.

Pack hot cocoa packets and chicken broth packets in a Ziploc bag and store them in your medical trauma bag/kit. Yes! When a patient’s core temperature is significantly low and they have either entered hypothermia or are borderline, the beverage will heat them up and provide some caloric energy. Do not forget your lighters and matches! Stock up on them and waterproof them in Ziploc bags. Have as a backup a metal match (Magnesium block with a flint striker back) and some commercially-made waterproof matches. Read “To Build a Fire,” by Jack London to throw you into the proper mindset of the importance of fires.

4. Avoid frostbite by keeping the extremities warm.

Now let’s throw in a few recommendations regarding hand and foot warmers. You’re all undoubtedly familiar with the ones that start when exposed to air, such as the “Hot-hands” brands. These are important both for their individual use and also to heat up IV bags. Yes, in a severe trauma situation, you want to warm the fluid up before administering an IV to a patient. You can buffer the bag and seal in the heat by rubber banding the hand warmer to the side of the bag and sticking the whole unit into a 12-13 ounce Mylar bag (a Doritos or potato chip bag will do just fine), and tying off the top to speed up the heating process.

Shield your IV bags by wrapping them in felt of the type you find within an army issued canteen cover. Insulate your bags from the cold with this felt and with layers of newspaper. Your job is to create enough air-filled dead space between the cold and your IV bags to insulate them. You can also wrap them with pink Owens corning insulation…just be careful to clean off the outside of the bags first and ensure the port (for infusing) is free of fiberglass particles.

There is also a type of hand warmer that has a gelled substance inside and when you bend a little metal coin inside of it, the coin initiates a heat-producing reaction within the gel. This type of warmer is reusable, as well: one needs only boil the bag and make the gel run clear, cool it off into a liquid state, and it can be used again. I am unsure of the brand, but I have several with the “Angry bird” characters on them that I obtained in the infant/baby section of Wal-Mart, originally intended as a bottle warmer.

5. Keep your core warm.

Space blankets and ground pads are a must. You need to keep your patient well-insulated from the ground. You should already have them for yourselves, but with the aid bag keep another set. Why? You must remember one of JJ’s rules on this one:

1. When treating a patient, do not use your own supplies, ‘lest you become a casualty and have none for yourself!

This brings us to a related and equally important JJ rule you need to commit to memory, as it holds sway in all you do in Wilderness Trauma medicine:

2. You cannot effectively operate (the medic is referred to as an “operator”) if you become a casualty!

Keep in mind that in some conditions 40 and 50% of heat loss from the body can occur through the head. Therefore, having proper head gear is essential to maintaining proper body heat. As well, ensure that you have clothing layers in your pack at all times. This will help you to further insulate your core and maintain a proper body temperature. Consider these suggestions.

5. A good waterproof poncho can go a long way.

Another thing you can use is a good poncho (U.S. Army issue preferred, because it has grommets that are really strong and durable) and 5 bungee cords. This can be rolled up along with the bungees. Remember to protect the poncho from the bungee cord hooks! You can do this with an old sock to cover those hooks when you bundle the cords together. Slip ’em all in the sock, and then roll the poncho around the whole thing.

You can string a bungee on each of the grommeted corners and the fifth wrap/coil around the hood for a vertical support for a temporary bivy hootch/shelter. Trust me, taking care of a patient in a pouring rain is a very difficult and exasperating thing. In this light, make sure you waterproof all of your supplies. All of them. This should be during the summer, and in the wintertime it is even more critical.

6. Keep your feet warm and dry!

Foot gear is also important: not just boots, but also some heavy socks, in a Ziploc bag to keep in your medical kit. I know, I know, it seems unrelated to medicine; however, when that patient has no spare socks and he is suffering from frostbite or exposure, what are you going to give him or her? Dry foot gear will go a long way, and heavy wool socks are what you need. When he or she has been evacuated, then retrieve the socks, wash them, and replace them in your medical kit/bag.

These are some helpful basics that will enable you to round up some supplies and a game plan for your winter first-aid kits. The next installment of this series will cover some first aid procedures to follow, as well as different types of cold weather injuries. Each of these cold weather-related injuries we will explore in-depth on an individual basis. In this manner we can train you up whether you’re just hiking and fall victim of an accident or a long-term hunting trip turns into a life-threatening scenario. Until then, keep your powder dry and your hands warm!

JJ

The information presented here is not meant to, nor does it diagnose, treat, recommend, or prescribe any care or actions. Only a licensed, certified, medical doctor is qualified and authorized to take such actions. Consult with your family physician prior to undertaking any and all activities as mentioned herein.

This article was originally published at Ready Nutrition™ on September 24th, 2015